沙格列汀联合二甲双胍对磺脲类失效的2型糖尿病患者胰岛功能的影响  

Effect of metformin combined with saxagliptin on the function of islet in type 2 diabetes mellitus patients with secondary failure of sulfonylurea

作　　者：莫小庆 黄春[1] 周波[1] 宋青青[1] 刘洁[1] MO Xiaoqing;HUANG Chun;ZHOU Bo;SONG Qingqing;LIU Jie(Department of Endocrinology and Metabolism,Center People′s Hospital of Zhanjiang,Zhanjiang 524037,Chin)

机构地区：[1]湛江中心人民医院内分泌代谢科,湛江524037

出　　处：《西北药学杂志》2018年第3期395-398,共4页Northwest Pharmaceutical Journal

摘　　要：目的研究沙格列汀联合二甲双胍对磺脲类继发失效的2型糖尿病患者胰岛β细胞功能的影响。方法选取对磺脲类继发失效的2型糖尿病患者84例。根据随机数字表法均分为2组。对照组予以二甲双胍治疗,观察组则在对照组的基础上加用沙格列汀。治疗12周后,对比2组临床疗效、治疗前后血糖、三酰甘油、总胆固醇、成人体质量指数(BMI)水平、胰岛β细胞功能变化情况以及不良反应发生情况。结果治疗后,观察组患者治疗总有效率(95.24%)显著高于对照组(78.57%);观察组空腹血糖(FPG)、餐后2h血糖(2h-PG)和糖化血红蛋白(HbA1c)水平分别为6.0±1.0mmol·L^(-1)、7.4±1.2mmol·L^(-1)和7.4%±1.3%,显著低于对照组的8.8±1.7mmol·L^(-1),11.3±2.2mmol·L^(-1)和8.2%±1.6%。观察组患者三酰甘油水平显著低于对照组。观察组胰岛素(INS)、C肽(CP)水平分别为24.5±4.7mU·L^(-1)和1.7±0.5μg·L^(-1),显著高于对照组的18.9±4.2mU·L^(-1)和0.9±0.3μg·L^(-1)。2组患者低血糖、胃肠道反应以及腹泻发生率对比均不明显。结论沙格列汀联合二甲双胍应用于磺脲类继发失效的2型糖尿病患者具有显著的临床疗效,可有效改善患者胰岛β细胞功能,安全性较好。Objective To study the effect of saxagliptin combined with metformin on the function of isletβcells in type 2 diabetic patients with secondary failure of sulfonylurea.Methods84 cases of type 2 diabetes patients with secondary failure of sulfonylurea were selected.According to the random digital table method,the patients were divided into 2 groups.Patients in the control group were treated with metformin alone,while the patients in the observation group were treated with saxagliptin based on metformin.Both groups were treated for 12 weeks.The clinical efficacy of the 2 groups were compared.Before and after treatment,the blood glucose,triglycerides,total cholesterol,BMI levels,the changes ofβcell function and the adverse reactions were compared.Results The total effective rate of the observation group was 95.24%,significantly higher than that of the control group 78.57%.After treatment,the observation group FPG,2 h-PG and HbA1 clevels were 6.0±1.0 mmol·L^-1,7.4±1.2 mmol·L^-1 and 7.4%±1.3%,significantly lower than the control group 8.8±1.7 mmol·L^-1,11.3±2.2 mmol·L^-1 and 8.2%±1.6%.The level of triglyceride in patients after treatment was significantly lower than the control group.The INS and CP levels of the patients in the observation group were 24.5±4.7 mU·L^-1 and 1.7±0.5μg·L^-1,significantly higher than that in the control group 18.9±4.2 mU·L^-1 and 0.9±0.3μg·L^-1.The difference of hypoglycemia,gastrointestinal reaction and diarrhea incidence in the 2 groups was not obvious.Conclusion The combination of metformin and saxagliptin in the treatment of type 2 diabetes mellitus in patients with secondary failure of sulfonylurea is safe and effective,and can improve the function of isletβcells.

关 键 词：二甲双胍 沙格列汀 2型糖尿病 磺脲类继发失效 胰岛Β细胞功能 

分 类 号：R977.1[医药卫生—药品]